310870_Inspection_20170101

Facility Number 3 f r1D Date of Inspection / DO
Time of Inspection 24 hr. (hh:mm)
E3 Permitted ® Certified ® Conditionally Certified ® Registered JE3 Not O erational Date Last Operated:
Farm Name: �l..e j.> 1cs�. .....l.�Ernah �o�"ti....................................... County:..��...�%in.................................... .
............... ..................... ......................
Owner Name:....... �ro9.! . A l �1............... Ale hA t 1 Phone No:....................................................................................................
Facility Contact: .........
Title:.......
Phone No:
MailingAddress: ..................................................................................................................... .....................................................................................
Onsite Representative: Y' N e W ' y o/
l ` ��` b� bf� `�..1` G%r ..�1.......... Integrator: !°7 "o)z a m S ............................
Certified Operator:.................................................:.............................................................. Operator Certification Number:,
Location of Farm:
.......................................................................................................................................................................................................................................................
r................. ....... .....................�
Latitude Longitude
Design ;Current
Swine Capacity ' Population
❑ Wean to Feeder
® Feeder to Finish
3
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design 'Cu'rrent
Poultry Capacity. Population ' Cattle' --.,:Capacity Population
❑ Layer FEJ
Dairy
❑ Non -Layer Non -Dairy
❑ Other
Total Design Capacity._
Total SSLW-
Number of Lagoons" • JE1 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Hblding Pond's /-Solid-Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? El Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If ycs, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than_from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ..........22 ...................................................................................................................................................................................................
.........
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
3/23/99 Continued on back

Facility Number: Date of Inspection T/o0
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the. waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This'facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
El Yes
El No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
$ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
[K No
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
; 10 yieai6s;or• difcendLA9 *6rb noteddiirwiourii: h1fther
corresporidence'abouthisyst;
Comments (refer'to quesfion'#):` Explairrany-YES;answer'sand�or anyyrecommeplotions or any o.tl er,comments:;.
K•,
Use drawings -of facility to better.explainsituations:(use'additiobal pages �as.necessary) -
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-<A,m Id be ker--> w;A 44,-
Reviewer/Inspector Name e l�/G1 ! !.' l �j S . l� , �� 3 Jam- ¢ 71,...Zip
Reviewer/Inspector Signature: ��„r1 �i� 7E' � Date:

Facility Number: Date of Inspection DO
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
❑ No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
❑ No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments And/or Drayvings:. J
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3/23/99

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Facility Number I 8 O Date of Inspection 23 od
Time of Inspection © 24 hr. (hh:mm)
,® Permitted ® Certified ® Conditionally Certified ® Registered 113 Not Operational I Date Last Operated:
Farm Name: e 1 �`' �e �Ot.................G�...........:.!.�......... ......... �........ �!....'..�.................................... County: �.tl.1.4.. �.:.`.:1..........................p...............�....r.............
Owner Name:... 5..��...... .Ld ..... e..'.!.� r'L........................................... Phone No:CQ.� j-2G) 011.0..-..�'�...a....(..`. 2.�.T7............
........ ..... .......
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
MailingAddress: .....................................................................................................................
Onsite Representative: $� 6 �/ %C y �'l A/ei ;,�
CertifiedOperator: ............................. .................... ; . .............................................................
Location of Farm:
Integrator: �►i u ^ ti F� ""`� r
Operator Certification Number: ..........................................
Latitude �•�� �« Longitude
Design', `Curr6nt--' Design, Cur`rent''
,Swine Capacity, -Population Poultry Capacity° Population ` `°Cattle..
❑ Laver ❑ Dairy
❑
Wean to Feeder
® Feeder to Finish 173 7,3 If If
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
J❑ Non -Layer I 1 1, J❑ Non -Dairy
❑ Other
Total; esigh, Capacity*;
Totat'SSLWzy
;n,� , i Cu'rrent
:.'Numberof:Lagoons :�z'°` , ❑Subsurface Drains Present ❑Lagoon Area _ ❑Spray Field Area
Bolding Ponds'/Solid-Traps I
10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑Yes E] No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a..If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 10 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes � No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes M No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Freeboard(inches) .........21 ................................................... ................................... .................................... ..... ............................... ....................................
.......... .
5. Are there any immediate'threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes f9No
seepage, etc.)
3/23/99 Continued on back
J❑ Non -Layer I 1 1, J❑ Non -Dairy
❑ Other
Total; esigh, Capacity*;
Totat'SSLWzy
;n,� , i Cu'rrent
:.'Numberof:Lagoons :�z'°` , ❑Subsurface Drains Present ❑Lagoon Area _ ❑Spray Field Area
Bolding Ponds'/Solid-Traps I
10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑Yes E] No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a..If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 10 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes � No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes M No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Freeboard(inches) .........21 ................................................... ................................... .................................... ..... ............................... ....................................
.......... .
5. Are there any immediate'threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes f9No
seepage, etc.)
3/23/99 Continued on back

Facility Number: "31 —,9701 Date of Inspection 5 23 CJO
1
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes Fkj No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes M No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes IQ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ]KNo
Waste Aanlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes g No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes M No
12. Crop type Qe r m vdc, %i a Sr►, a. GI �a �' C o r n, c ity c it So � h 1 a -1, {
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? Er Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? 0j Yes El No
18. Does the facility fail to_ have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ,SJ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) Dff Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes j No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes] No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ® No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ® No
24. Does facility require a follow-up visit by same agency? Fz5] Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes O No
.; .im yiolaiicjns.or.efciencies •mere potted• diiririg •(;leis;visit; • ;X;oi� will reoeipe -lio further. ;
;t or'r ... ncdence: about: this visit:
Comments (refer to,quesiiiori Explain-any°YES.answers.and/or-,anyreeommendations oia'ny other:comments.
Use drawin s of facility to`betft explain situations: (use 'additionatpage&asineeessary),
AL
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Reviewer/Inspector Name ��o f? c we % .,G1�1� , f /O�
Reviewer/Inspector Signature: Q Date: "V:2_7 /Oc)

Facility Number: f — �7� Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes J] No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes M No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes J31 No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 10 No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes �K No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes R No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes Eg No
Additional Comments and/or DraiWings:�
IJ
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.A

Division of Water Quality, o.
0 Division
Soil and V�tki Conservation
O Other Agency
Type of Visit to Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit O Routine OComplaint O Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit:
Permitted rtified 1[3 ConditiQn lly Certified [3 Registered
Farm Name:
��G� / l6
f�
Owner Name:
Mailing Address:
Facility Contact: Title:
t
Onsite Representative: d✓�� �� /, f��
Certified Operator:
Location of Farm:
Time 0Q
Date Last Operate r Above Threshold: _
County: 6�,E-�
Phone No:
Phone No:
Integrator:
Operator Certification Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 C « Longitude 0 ° «
Design a , Current
swine Capacity Population
❑ Wean to Feeder
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current Design Current
Poultry Capacitv Population Cattle Capacity Population
❑ Layer I 1E3 Dairy I
I
❑ Non -Layer ❑Non-Dai
- - --- -
❑ Other
Total Design Capacity
Total SSLW
. Number of Lagoons ILI Subsurface Drains Present IIL Lagoon Area ILA Spray Field Area
Holding Ponds / Solid Traps i ❑ No Liquid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ONO
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance roan -made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ;ErNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): 23 -2
05103101 Continued

Facility Number: Date of Inspection e
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
El Yes
El No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
AYes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
&No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
�No
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
® No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
comments (efei to -question #}: Explain a ay Y S ansWkis and/or aiiy�recomiiiendations or a *'other comments.
Vse drawings-oi aeilaty to better,explam sitfiatf6ns�i (use'ad litional.pages'as necessary) Field Copy _❑ Final Notes
NS�'��C% �OiJ d'�� �-lG-r�,D �F-�'fI uvE �% �CTr.�.�,�= ��✓� �� /'��� �o ci,Lc-
014 NpJ. ?,� do3_
Reviewer/Inspector Name it x,
Reviewer/Inspector Signature: z ZMD Date: Y�
05103101 Continued

Facility Number: — Date of Inspection 2 4
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ElNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. N ere any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s). inoperable shutters. etc.) ❑ Yes ❑ No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments and/or Drawings:
A, �51- I -, -411A
Z:4
A5
4IP44e-�%�p rTIC 2 aA 1/5
.
xc�
7,- Ic ",a
;�
05103101

Division ofi'Vater Quality,
i,Divisiun ofSoii aiid`, Ater 6nservation
��Other,en+cy ,
Type of Visit Q-Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit '(J�Routine 0 Complaint 0 Follow up 0 Emergency Notification O'Other ❑ Denied Access
Facility Number2
Date of Visit: �' Z ®Z'Time: '?
Not Operational 0 Below Threshold
® Permitted ® Certified ® Conditionally Certified ® Registered Date Last Operated or Above Threshold:
Farm Name: Awilvl Kt'h County:
Owner Name:
Mailing Address:
Facility Contact: Title:
OnsiteRepresentative: __ 6Ply
Certified Operator:
Location of Farm:
Phone No:
Phone No:
Integrator: &L&A4 //
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 1 OK Longitude ' ° �u
Design, , Currents Design Current; DesignCurrent
Swine ., Capacity .Population Poultry Capacity Population ;Cattle Capacity Population
❑ Wean to Feeder JE1 Layer I Dairy
® Feeder to Finish 734W 10 Non -Layer I I Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total DesignfCapacityl
❑ Gilts
❑ Boars _ Total SSLW
Number, of %goons�u; . �: . ❑Subsurface Drains Present ❑ Lagoon Area 10 S rav Field Area
kiolding Ponds !Solid. Traps, 0` " , , ❑ No Liquid Waste Management System .
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon ❑ Spray Field El Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: I
Freeboard (inches):
05103101
❑ Yes 1jNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 9No
❑ Yes ':No
❑ Yes N-s!KNo
Structure 6
Continued

I.
Facility Number: _7 —;67 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
KLNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
-No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
1KNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
),R.No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
�4No
elevation markings?
❑ Yes
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
E-No
11. Is there evidence of ver application?? ❑ Excessive Pondding ❑ PAN ❑I Hydraulic Overload
❑Yes
b5No
12. Crop type �tl�� / / �il%li���/! (/ tG✓� C o6�i �� �fY
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
QNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
S-No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
�J_No
16. Is there a lack of adequate waste application equipment?
❑ Yes
P No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
®No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
ZNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
91 No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
9No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
MNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
1E] No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
®-No
24. Does facility require a follow-up visit by same agency?
❑ Yes
'[No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
EkNo
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments .(refer to question #); Explain any YES, inswers and/or.any recommendahons.ar aav ether comments.,,", -
�Use drawings of facility td,better--explamsittia&ons._(use;adti�i�onaCpages asnecessary):"'� "; ❑Field Conv❑ Final N otes���
.4J_14- �Q✓p�1�.�/ '
Hw
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 � Continued

Facility Number: ;1l — Od Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑Yes jNo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �K No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes (-No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes �g No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes 8q. No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes EZ—No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes G No
'Additional Comments and/or Drawings:
O5103101

Division.of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance inspection O Operation Review O Lagoon Evaluation
Reason for Visit 'Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: i 31 Di Time: 67,10 Printed on: 7/21/2000
E: Facility Number 31t'J(�
® Not Operation, ® Below Threshold
❑ Permitted ® Certified ❑ Conditionaliy Certified ® Registered Date Last Operated or Above Threshold: .........................
Farm Name: s �`d. ..... G "� F-c ✓ "ti County: ... j2v O /!......................................... ..............
OwnerName:......... �t ... ......` l........... ........................................................................ Phone No:.......................................................................................
FacilityContact: .............................................................................. Title:................................................................ Phone No: ...................................................
Mailing Address: .....................................
Onsite Representative:._ bb o G�4r'„ !'7^ ._.��? ''l. Integrator: , °�'^ �I.
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Locationof Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �° �� ��� Longitude
Design Current
canne-ity pnnnlatinn
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Gilts
❑ Boars
lmer'W`14igogns`'
Design Current Design 'Current
Poultry Capacity Population Cattle Ca 'ci, :';Po` ulation
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
T®tl. SSLW
Subsurface Drains Present 1I❑ Lagoon Area I❑ Spray Field Area I:
No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/ruin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection &; Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: I
...................................................................................................................................................................................
Freeboard (inches): fj
S/00
❑ YesXNo
❑ Yes XNo
❑ Yes ZNo
n I q
❑ Yes JZNo
❑ Yes zNo
❑ Yes ZNo
❑ Yes �ETNo
Structure 6
Continued on back

/-gr7o
Facility Number: Date of Inspection d O 3d t51
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes effNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes ONo
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes ZI-No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes ,fJ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes O^No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes j-No
11. Is there evidence of over application? ❑ Excessive PondingPANiydraulic Overload
Yes ❑ No
12. Crop type ��r.Muo��, � ze,Sy�r�t�l Grn-°". / C"', ) Wkcor+- �a`aljG��tih�s
13. Do the receiving crops differ with those designated in the Certified AnimalWasteManagement Plan (CAWMP)?
❑ Yes , ETNo .
14. a) Does the facility lack adequate acreage for land application?
❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
❑ Yes ❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes ❑ No
15. Does the receiving crop need improvement?
❑ Yes ,® No
16. Is there a lack of adequate waste application equipment?
❑ Yes, 6No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
ff Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes J214o
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
IATyes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes .,ETNo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes ZrNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
> r"
(ie/ discharge, freeboard problems, over application)
❑ Yes o tL
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes XNo
24. Does facility require a follow-up visit by same agency?
❑ Yes ffNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
PYes ❑ No
10-Ab atidiis:or• defcpendbeg *ere ngted• di ihdthis: SIC • Y;oif-mrdi•reeeiw ii® fucth�r
6iresa6ridence: ahou>" thi's visit: .................................. .
:omments (refer to question #): Explain any YESanswers and/or any recommendationc`or any other; conunents;
ise drawings of facility to better explain situations., (use additional,pages,as necessary),-.`_,.,
nJ
�v 6 F?2�✓iGf' . ; �� © o Yt';� lot �� u ne �1
�, • l AL
d-1��(`G 1, O ,/�''�� � i Cam: T
tq I6_5%rtCr4 ol 2.00l Ger er d �� ~�v�; �l Gv���o �c� P i,01A Z
1q. OceA Ce y-4; Fi c4e o P C&,/ a'�a t tie► I ��� b� ��
Reviewer/Inspector Name
Reviewer/Inspector Signature:
e
1, ..- -.,1.; .w
Date: l 01-31 Mt_ 5100

Facility Number: Date of Inspection 3l
'Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below /Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes )aWo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes _JjTNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes "I
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes - TNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes , Z No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments -an orDrawings:
6O�jACL-�S oP
61/'C1+'s �Li
cal t c', On -�4e =�(1�- �.� S� - s ✓mil nc� 45,7 '/ r'o,
A p L^i l � �&� ne 2-vol G1��G ��G � J' �i^� �V�"3 j� 1 0 �- See ./10 ✓l- c S%D .a.+ " j,
J
4t, pulls en 4tve �rcS�lC 1�'��� ' %UeeA Zo(g j s01 � 4C-4 �do•-e 44e
eixet of Ike %e'e)r'%a'.rfl d'°►tee aeeE� <' ��. ale '(i "b'eclpc, recorrl.$
2Z.. Fce-booi--d /erwy-6 S S�i/W �rAG�1i�L ►t'L-� ih l CtrCi� �D �j�Q�'}1
,7061 ✓ s d'i d� i,C �(/� i/�' �, `L�lP�1� ►►-�`-r�rC~c� 7^iQert �6 G keG Get iCi &,r
h luo-,A 4E, Atte -) i✓'�',t ��i �`a� a�85 ��y�+o
P'VR
�Arc<<sP4'/E �� c�Q� ; cr.�S .,r c1� nezp
6e'pd-� 1&6�4100J
Illo4e : ��na '� rS h�-�1
5100

ivision of Water Resources
Facility Number - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: _'QCom fiance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: /�p�% � Departure Time: County: IX
Farm Name: �(�, N l,� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: c otl*h Q � �( Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Dry Poultry Canacitv Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? -(If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Region: L)
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes „❑"No ❑ NA ❑ NE
❑ Yes 0 No
❑ Yes PI -No
❑NA ❑NE
❑NA ❑NE
❑ Yes
2 No
❑ NA
❑ NE
❑ Yes
P�T'No
❑ NA
❑ NE
[—]Yes
eNo
❑ NA
❑ NE
Page 1 of 3
21412014 Continued

Facili Number: jDate of Inspection: 2
Waste Qallection & Treatment
44. Istorage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes Jallo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ETNo
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
��
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes 'oNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes 3-No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes Lallo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes ;2No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes JZ No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes P No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
.,,0
❑ Yes ,fNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes jn'No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes E]-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes /0-No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes O—No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes O No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists [:]Design ❑ Maps [:]Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ;2No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �N0 ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes J2 No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: 31 - kz jDate of Inspection:
24%Did the4facility fail to calibrate waste application equipment as required by the permi . ❑ Yes
No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
�No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes
P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes
Prilo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes
No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes
O'No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes
KNo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
7110 ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
No ❑ NA ❑ NE
V�No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑ No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
berg ace d- yIa -k k
'-2 r s
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Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: /A41A/
141 014
i

JW Division of Water Quality
Facility Number 3 f %j O Division of Soil and Water Conservation
i,. O Other Agency
Type of Visit 0 mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
',,%�
Date of Visit: G Arrival Time: i U Departure Time: County: L41 / Region:
Farm Name: 5-IR G f?22!t'! ✓� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: / Title: Phone No:
Onsite Representative: �E'C/Gca Z�A Ze� Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
4-11
Operator Certification Number:
Back-up Certification Number:
Latitude: = o Longitude: = ° = 1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
i
❑ Non -Layer
Dry Poultry
❑
La ers
i
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
j
'Other
'
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [ 'No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑Yes El No
❑NA
❑NE
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes , 0 No
❑ NA
❑ NE
❑ Yes -2rNo
❑ NA
❑ NE
12128104 Continued

Facility Number: 87 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a }}
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes _.No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ; >o ❑ NA ❑ NE
❑ Yes EI'No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes G-No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes O No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes eNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 2 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 2-No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes /nNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes—ffNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[:]
yes ,,ETNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes ElNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes .El -NO
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
64
Reviewer/Inspector Name V J Phone:
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: — 7O Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUp ❑Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. �es 2MNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes FKo ❑ NA ❑ NE
❑ Yes -1fNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
j L
❑ Yes 2No ❑ NA ❑ NE
❑ Yes
E]"No ❑ NA
❑ NE
❑ Yes
❑ No E] NA
❑ NE
❑ Yes
❑ No .21A
❑ NE
❑ Yes�No ❑ NA
❑ NE
❑ Yes
❑ No ❑ NA 21NE
❑ Yes --El—No ❑ NA ❑ NE
❑ Yes ;2'No ❑ NA ❑ NE
❑ Yes Plo ❑ NA ❑ NE
❑ Yes -2'Nlo ❑ NA ❑ NE
❑ Yes J2':lo ❑ NA ❑ NE
❑ Yes <o ❑ NA ❑ NE
4-,c) recrr1'6?11-7
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-� G�CGor
5
G'c 5- 1h '/
12128104

ivision of Water Quality
Facility Number O Division of Sail and Water Conservation
Other Agency
/", L/b
�•
�
'
Type of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit,"Routine O Complaint 0 Follow up O Referral O Emergency 0 Other [IDenied Access
Date of Visit: IArrival Time: l ft�A eparture Time: County: ljL Region:
Farm Name: —A-WI
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: —
Back-up Operator: _
Location of Farm:
13
'Design Current
Swine Capacity', opulation
❑ Wean to Finish
ElWean to Feeder
ElFeeder to Finish
ElFarrow to Wean
ElFarrow to Feeder
ElFarrow.to Finish
ElGilts
ElBoars
Other . � : . �•
❑ Other I
Title:
Owner Email:
Phone:
Phone No:
Integrator•
Operator Certification Number:
Back-up Certification Number:
Latitude: [= e = g = Longitude: = ° =1
Design Current
Wet.Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharges &Stream Imuacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: , El Structure El Application Field El Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population,,
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [�No El NA El NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
� No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
10 No
❑ Yes
16 No
❑ NA
❑ NE
❑ Yes A No ❑ NA ❑ NE
Page 1 of 3
12/28/04 Continued

Facility Number: 31 - 701 Date of Inspection: 2 Zl
Waste Collention & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: i
Spillway?: _
Designed Freeboard (in): _
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Structure 6
❑ Yes ;Z No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes WrNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �'No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes '&No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes PfNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ZlNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes J"No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ;2-1�o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes JZ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes ZNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Z No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: t2 X1
24. Djd the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [;No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes L �J No ❑ NA ❑ NE
the appropriate box(es) below. T
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes d No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes �/ No ❑ NA ❑ NE
v
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
� A
❑ Yes `t-' No
❑ Yes No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes � No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [1 No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes `P No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
6//�i//z
51 -_711L z�sS
;4 / 2, 0 // 7.11
Reviewer/Inspector Name:
Phone: '/L/1— l i &
Reviewer/Inspector Signature:
Page 3 of 3
Date: 12i/2U //�7

Lac�ifitLyNumber
6J Division of Water Quality
® Division of Soil and Water Conservation
® Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance CAS Reason for Visit 0 Routine Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 3 'L v Arrival Time: I 1 a O 67 Departure Time: County: DUPLI O Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: ZegCZ� V A 00
Certified Operator:'KC'—G1:rJNUD V.C—,IJ k 0
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Title:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = { = Longitude: = ° = ` = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifej
❑
Dry Cow
❑
Non -Dairy
I
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

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Facility Number: 31 — Date of Inspection 3 0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and'maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
E.-T/Ye s
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33.
Does facility require a'follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
1/ Fee, Z8run-7 , � E DL0 ?uAAP F, 4w\ Agout, -1 a earn �a 1 pt,,, Ac-cotzp r,34
o ' 14 rS S�Ai� r�,N�. N � tb pm t4C- W 4-Ufi q rj b C.A C-,C'Kk9 o A/
}� j\PCL1tCATzol j AWfl VooWD - t,/5IC- t?6NGz-W(=_ on1 "Cwe E.EE>,n.
d�E i ► ee e -Fq_ �uYL�1J a Pr' `rtE ? uK'\_e-r0G- Ei2U= P cv �►O 1 ,
aF' LS � J 1 O ?' A V L.LC. oV ca�LA FAO W 'A S
i tb� PP �° �'tt�A C� W Q ,ii1J a 1't r� CL. �► are NF n- s_Clq rEo
USA- ,CScNS� �,/qS 1�1y Fo(i Aijo 6-0 31'407 FNx. Cfie-e WAS IZE�E v EYJ
?AOT S fAlgtj FE6,2'9 WSrLo oFFZCC- R"ZCUO) MAR, I LATE Wr"- hto"_11 I,_jS1'6CT'E9
(V1AV. 2) v%A*A,6J&,
12128104

V
Ile
yy f
r•. �-Ji '""'nT � "ILL-:.. - I '{r, f '�y •.. ' -
._ . , f, =�'... _ ,,. . •tom %• : 7 _ �„ `"." -

03/05/2007 10:23 9102937437 S.REGINALD KENAN
PAGE 01/02
S. REGINALD KENAN
ATTORNEY AT LAW
115 WEST HILL STREET
P. 0. BOX 472
WARSAW, N. C. 28398
[phone]
FAX [phone]
: il
DATE:
MESSAGE TO: hczk,s � . c
FIRM:
NUMBER OF PAGES (INCLUDING COVER SHEET):
TELECOPIER NUMBER: I -
MESSAGE FROM:4nSnc" 6p4rwo
SENDER'S DIRECT PHONE NUMBER: 910-293-7801
SENDER'S TEEECOFIER NUM ER: 910-293-7437
SPECIAL INSTRUCTIONS:
TRANSMITTER:

4 0
03/05/2eO7 10:23 9102937437 S.REGINALD KENAN
PAGE 02/02
water rollu )plem operators
C`ertifu, mission
Sebastian R- Kenan
Jim r oride Cerw
AWA -
i. d A* r-dftd C**—, -h4- prwi.pfvs of, I Pdek 'A QpW *44 0/
the r�Ru— -, 6NA ( �.f of,'04"t
PUFF Rawh
2007

vision of Water Quality
Facility Number 1 CJ Division of Soil and Water Conservation
Other Agency \
Type of Visit !2f Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: a Arrival Time: Departure Time: County: Region: lT
Farm Name:
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: 6��/tt
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Title:
Owner Email:
Phone:
Phone No:
Integrator: M / (&
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = g = Longitude: = o = g = tf
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Other
❑ Other _
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑
Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures: IDJ
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 'No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes /2FNo
❑ Yes /LI No
❑ NA
❑ NE
❑ Yes ZNo
❑ NA
❑ NE
Page 1 of 3
12128104 Continued

Facility Number: Date of Inspection 2 /G
Waste Collection & Treatment
4. ds storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 9No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any. immediate threats to the integrity of any of the structures observed? ❑ Yes oNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ffNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance ci improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes /No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes YNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ZNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ;dNo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes ZNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes /EI'No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
AL
Reviewer/Inspector Name Phone: G-?QC--%
Reviewer/Inspector Signature: Date:
1z1_1v1/4 - uonunuea

Facility Number: Date of Inspection G
Required Records & Documents
19., Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 2No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Z No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other ,�/
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes �J No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ' ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes ,ENo ❑ NA ❑ NE
❑ Yes KNo ❑ NA ❑ NE
❑ Yes ZNo
❑ NA
❑ NE
❑ Yes oNo
❑ NA
❑ NE
❑ Yes �No
❑ NA
❑ NE
❑ Yes ZNo
❑ NA
❑ NE
❑ Yes j2 No ❑ NA ❑ NE
❑ Yes JZ'No ❑ NA ❑ NE
❑ Yes -CJ No ❑ NA ❑ NE
❑ Yes ,ZNo ❑ NA ❑ NE
❑ Yes -ffNo ❑ NA ❑ NE
❑ Yes &No ❑ NA ❑ NE
Additional Comments and/or Drawings:
V
12128104

�rvision of Water Quality
Facility Number V Division of Soil and Water Conservation
O Other Agency
Type of Visit 0 C mpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Z230J Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: &5 G1it-7
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Owner Email:
Phone:
Phone No:
Integrator:��T
Operator Certification Number:
Back-up Certification Number:
Latitude: = q = { = « Longitude: = o = g = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La er
❑
Wean to Finish
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
Dry Poultry
❑
La ers
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes tNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
XJ N"o
❑ NA
❑ NE
❑ Yes
Z(No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Oyes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1/
Spillway?:
Designed Freeboard (in): J
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes O'No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes f No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ,ONo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �JNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ yes P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes oNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ZNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ YesZNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes ,fI No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes XNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ONo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name y� Phone:
Reviewer/Inspector Signature: e� Date: f `l Q
fI
12128104 Continued

Facility Number: — Date of Inspection l d
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ZYes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ff No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑. Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below.] Yes J2 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑, Waste <Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ,❑'No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Z No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes O No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes 2'No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ETNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes P No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes gNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ONo ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes JZ'No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ETNo ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes dNo ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes Elfqo ❑ NA ❑ NE
Additional Comments and/or Drawings: ' 1
AL
�- A
/ d �/ Wv ,//pf%, p)
610 0/0 eJV/V1/0/
y a�
jlb
4 r1
rr 12128104
t

vision of Water Quality _
Facility Number O Division of Soil and Water Conservation
U Other Agency
rof Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
n for Visit ,,�outine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 22�/Y—,, ' rival Time Departure Time: County: Region:
Farm Name(
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact: Title:
e
Onsite Representative: X44�
Cof �9;�
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: [= o = S = Longitude: = o = i
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑
Wean to Finish
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity jPbpulation
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:, =
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 2rNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
- ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
[ Ko
❑ NA
❑ NE
❑ Yes
[;�'Ro
❑ NA
❑ NE
Page I of 3 12128104 Continued

Date of Inspection
Facility Number: —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Ello
❑ NA El NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA ❑ NE
Struc e 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
4No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[2"No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
VNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[�No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
gfNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
2TNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
��/
ICI No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ONo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes •ETN0
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes ONo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes ,ONo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑l No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name ., ar, Phone:
Reviewer/Inspector Signature: Date: l�-aD " •
Page 2 of 3 121281W c,'onanued

Facility Number: J — Date of Inspection
k9.id
d Records & Documents
the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
s the facility fail to have all components of the CAWMP readily available? If yes, check ❑Yes ❑ No ❑ NA ❑ NE
appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application [:]Weekly Freeboard ❑ Waste Analysis JZSoil Analysis ❑ Waste Transfers ❑ Annual Certification
/Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections Eymonthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes EtNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:,
be s'ee 14
Ah
❑ Yes
P No
❑ NA
❑ NE
Yes
ElNo
ElNA
ElNE
Yes
❑ No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
[;,No
❑ NA
❑ NE
❑ Yes 5�'No ❑ NA ❑ NE
❑ Yes [;'No ❑ NA ❑ NE
❑ Yes Eallo ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
❑ Yes EI—No ❑ NA ❑ NE
❑ Yes ❑INo ❑ NA ❑ NE
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